A9TaschdjianPorterButlerStarbird

A9TaschdjianPorterButlerStarbird

To Do

• 1. please work as a group (minimum: 2 members; max: 6 members) and submit one answer as a group (clearly identifying the members of your group)
• 2. Read:
  • Chapter 8 in Ben Shneiderman's book entitled "The New Medicine: E-Healthcare" (lecture on Oct 27)
  • Chapter 9 in Ben Shneiderman's book entitled "The New Politics: E-Government" (lecture on Oct 29)

Question 1

discuss what YOU consider the two major influences of information and computer technology on healthcare with comments on how these developments have changed:

• the healthcare business
• the doctor/ patient relationship (pluses and minuses)

Question 2

assume you need to inform yourself about some medical problem or issue (e.g.: high blood pressure, hip surgery, torn ACL or Achilles tendon, obsessive compulsive disorder (OCD), attention deficit disorder (ADD), you want to travel to a country in Africa (any precautions needed?), ....) - choose one example from the list or one chosen by yourself and

• explore the WWW about it, and
• describe what you found out and did not find out?

Question 3

as elections are coming up on November 4, 2008:

• identify the major differences between elections in 1980 (before the Internet, Social Networking, blogs, ....existed) and 2008!
• which new possibilities do you personally see as positive or negative developments?

Group response

1. Members of the Group

S. Butler, A. Porter, Z. Taschdjian, K. Starbird

2. Question 1

The two major influences of ICT on healthcare are the accessibility of health information through the Internet and the (still limited) automation and distribution of medical records.

Internet health care information empowers patients, giving them access to information formally held by the "expert" class of doctors. The impact of this emerging phenomenon on the overall health care system is hard to measure. Internet self-diagnosis may prevent some patients from appearing at health care facilities as they determine that their condition is treatable at home using over-the-counter medications. In some medical plans, informed patients may be able to refer themselves to experts, bypassing a primary care visit. However, there is also a chance that relatively healthy people will diagnose themselves with rare diseases and tax the system with frivolous visits. Patient empowerment can already be seen as having a drastic impact on the doctor-patient relationship. Internet-informed patients can be great patients if their information is accurate and used appropriately. They can also be terrible patients if they are over-confident about their Internet-enabled education and let it obstruct their interaction and first hand-diagnosis from a trained professional. At the same time, doctors need to adjust to a new balance of power in the relationship. They are no longer the only expert that patients have access to, and they need to value the self-educating that patients are doing.

One great potential for ICTs in the realm of healthcare is the automation and sharing of medical records through networks. Currently, this potential is only realized on a small scale, within some hospitals and medical groups. This automation saves patients from having to fill out redundant forms, synchronizes billing, and allows for smooth transfer of results between labs, experts, and primary care doctors. It eliminates a layer of bureaucracy within hospitals and medical groups. Automation and record sharing does not greatly impact the doctor-patient relationship. It may make in-group referrals easier for doctors and give patients more confidence in the process. It may also prevent patient frustration in the waiting room (filling out redundant forms) that can accompany them into the doctor's office and negatively affect the interaction there.

The full potential of ICTs in this realm has not been achieved. It is not even close. If medical records could pass easily from doctor to doctor and from hospital to insurance provider, the health care business could become more efficient in the use of both time and money. There are several reasons that this has not happened. The first is privacy, which is the best reason and will perhaps be the ultimate limitation on taking medical records "online." Other reasons include an initial overhead investment that health care businesses may be unwilling or unable to make, and a resistance by current providers to system change. As a student of ICTs, I am often frustrated by the overall lack of automation in our health care system and hope that this will change in the near future. It could save us all big money in our societal health care costs.

3. Question 2

In looking up high cholesterol on the web, we were able to find an enormous amount of information. The website emedicinehealth.com had over 14 pages of information, covering causes, symptoms, exams and tests, treatments, prevention, outlook, and others. Some of the factors they described were genetics, weight, activity level, age, gender, alcohol use, and stress. Their information was very detailed, in part because of the range of topics and items discussed, and in part because of their usage of statistics, facts, and research data. Their site lacked links to the research and data that they presented. They did include the address and phone number for the American Heart Association as well as two basic web links, but that was all of the resources listed. The Mayo Clinic (mayoclinic.com) has 10 pages on cholesterol. They cover a similar range of topics, but also include home remedies and alternative medicines. While their pages contained less information overall, each page included a few links to related websites on that specific aspect of cholesterol. At nativeremedies.com, they provided one long page providing information about statistics, symptoms, test score ranges, and a natural product treatment section. At the end of the article they included a list of references to Federal and National centers, but did not include references for claims of their natural products. They also included a single link to a cholesterol pill on their website - which did include some specific research results and testimonials.

All in all, it was very easy to find information about cholesterol, although the information wasn't typically connected to its references. In this scenario, the similarity of information between sites can provide a good starting point when considering the reliability of the information. We would feel comfortable making some of the dietary and lifestyle changes recommended before being given a prescription for lowering bad cholesterol. Although we could make that decision without a doctor's involvement, the initial blood testing to verify our cholesterol level would likely need to involve a doctor. For medical issues where there was no special test needed, it would be easier to make a self-informed treatment plan without a doctors involvement.

Website References Used: http://www.emedicinehealth.com/high_cholesterol/article_em.htm http://www.mayoclinic.com/health/high-blood-cholesterol/DS00178 http://www.nativeremedies.com/articles/cholesterol-education-heart-disease.html

4. Question 3

The election of 1980 between Ronald Regan and Jimmy Carter was marked by a number of important events that are typically hallmarks of any election. Interviews, debates, and conventions have all been chronicled into history. What is interesting is that all of these election events were mediated in some way by television or radio. So the question really becomes, what are the differences between the 1980 election, which was brought to the public via mass media and the election of today? First, we would argue that the Internet provides a space for extending the human memory in a much more salient way than the mass media of the 1980's. How would we even be able to learn about the 1980 election if it were not for the Internet? How would we go back and access the televised debates and the television interviews? In this sense, the Internet has obviously introduced a new level of access and record of election events that goes far beyond mass media. However, we think that Obama's campaign is extending the functionality of the Internet beyond these basic affordances and opens up a new terrain for elections. Obama's campaign is using texting to get the word out, which provides people the option to take immediate political action. These text messages often include a phone number to help people find their polling station, which is a key feature that helped get out the vote (Wired Magazine). The use of online phone banking techniques have also become a notable part of this campaign. In addition, online groups whose members endorse Obama are raising unprecedented amounts of money for him. "MoveOn also created an online Endorse-O-Thon widget that enabled its members to engage in a peer-to-peer online endorsement campaign by sending out 500,000 e-mails and Facebook messages to their friends recommending the candidate" (Wired Magazine). All of these examples, not to mention the new Obama ring tone, illustrate the public's willingness to be involved in the political process. We feel that the majority of these developments are positive and promote the decentralization of civic engagement in a way that supports democracy. Potential downsides are that it is increasingly impossible for voters to escape negative campaigning as election messages become more and more pervasive in our lives.

References:

The Tech of Obamamania: Online Phone Banks, Mass Texting and Blogs By Sarah Lai Stirland, Wired Maganize, 02.14.08.